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Patients in England denied vital cataract surgery

A freedom of information request conducted by the Medical Technology Group (MTG) has revealed that 104 of the 195 Clinical Commissioning Groups (CCGs) in England restrict access to cataract surgery.

A surgeon performing eye surgery on a patient obscured from view.

These CCGs include cataracts on their lists of ‘Procedures of Limited Clinical Value’, normally reserved for complementary therapies or cosmetic procedures where there is little evidence to prove their cost effectiveness or clinical benefit. This restricted access is happening despite guidance from the National Institute for Health and Care Excellence (NICE) issued in 2017 about the cost effectiveness of cataract surgery, stating that it has ‘a high success rate in improving visual function, with low morbidity and mortality’.

Helen Lee, Eye Health Policy Manager, RNIB commented:

“Cataract removal is a crucial procedure that has a huge impact on the lives of patients and their families. We know that restrictions or delays to cataract surgery can severely impact people’s ability to lead independent lives, making them twice as likely to experience falls and significantly reducing quality of life. It’s shocking that access to this life-changing surgery is being unnecessarily restricted by so many CCGs. We firmly believe that all patients who will benefit from cataract removal should be entitled to it and we urge CCGs to ensure the NICE guidance is fully implemented. Eye health services should be prioritised, so patients get timely access to treatment, rather than waiting months – or even years – for sight-saving surgery.”

We are joining forces with Ration Watch to challenge these restrictions. For more information about how you can challenge restrictions on access to cataract surgery take a look at our Cataract Toolkit at the bottom of this page.

Ration Watch

Ration Watch is a new campaign by the Medical Technology Group aimed at highlighting the issues around local commissioning and exposing examples of patients who have been denied life-enhancing treatments. The MTG is calling on NHS leaders to do more to ensure patient access is governed by what patients need, not where they live. The campaign’s website will show evidence of rationing, as well as the damage it does to patients and the NHS.

About cataracts

We estimate that there are around 677,000 people in the UK living with a cataract, 568,000 of which are in England. Cataracts are heavily linked to age, and more than half of the 568,000 affected will be people aged 80 years and over. People with the condition can experience severely impaired vision as the eye’s lens becomes opaque. Cataracts can affect one or both eyes and are treated by surgery, during which the cloudy lens is removed and replaced by an artificial lens.

The Royal College of Opthamologists states that it is important that patients regain as much vision as possible and are able to use both eyes together. However, a survey it conducted among ophthalmic leads in 2017 found some CCGs apply even stricter access to patients needing surgery on a second eye, meaning patients can have a cataract removed from one eye, but are then left with impaired vision in the other.